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Anti-herpetic Medications and Reduced Risk of Dementia in Patients with Herpes Simplex Virus Infections—a Nationwide, Population-Based Cohort Study in Taiwan
Open accessAbstract
This retrospective cohort study is to investigate the association between herpes simplex virus (HSV) infections and dementia, and the effects of anti-herpetic medications on the risk involved, using Taiwan's National Health Insurance Research Database (NHIRD). We enrolled a total of 33,448 subjects, and identified 8362 with newly diagnosed HSV infections and 25,086 randomly selected sex- and age-matched controls without HSV infections in a ratio of 1:3, selected from January 1, to December 31, 2000. A multivariable Cox proportional hazards regression model was used to evaluate the risk of developing dementia in the HSV cohort. This analysis revealed an adjusted hazard ratio of 2.564 (95% CI: 2.351-2.795, P < 0.001) for the development of dementia in the HSV-infected cohort relative to the non-HSV cohort. Thus, patients with HSV infections may have a 2.56-fold increased risk of developing dementia. A risk reduction of dementia development in patients affected by HSV infections was found upon treatment with anti-herpetic medications (adjusted HR = 0.092 [95% CI 0.079-0.108], P < 0.001). The usage of anti-herpetic medications in the treatment of HSV infections was associated with a decreased risk of dementia. These findings could be a signal to clinicians caring for patients with HSV infections. Further research is, therefore, necessary to explore the underlying mechanism(s) of these associations.
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In the citing paper
“HSV-2 seropositivity has also been associated with decreased memory performance, but appeared to be unrelated to global cognition and other cognitive domains, or the risk of all-cause dementia, AD, vascular dementia and other dementias [27,28].”
From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [28]
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Experimental — accuracy not yet measuredIn the citing paper
“This risk was nearly eliminated in patients that received antiherpetic treatment (Tzeng et al., 2018).”
From Alzheimer Disease: An Update on Pathobiology and Treatment Strategies (2019) · cites this paper as Tzeng et al., 2018
In the citing paper
“One study demonstrated a significantly increased risk of developing all-cause dementia (~3-fold increase) in patients greater than 50 years of age following a new HSV infection.”
From Alzheimer Disease: An Update on Pathobiology and Treatment Strategies (2019) · cites this paper as Tzeng et al., 2018
In the citing paper
“The advent of acyclovir, in the late 1980s, considerably modified the prognosis of HSV-1 encephalitis [54–56].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [56]
In the citing paper
“Previous research has found that the development of anti-herpes medications had a positive impact, reducing the incidence of AD [56].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [56]
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Metadata
- Authors
- Tzeng, N.-S., Chung, C.-H., Lin, F.-H., Chiang, C.-P., Yeh, C.-B., Huang, S.-Y., Lu, R.-B., Chang, H.-A., Kao, Y.-C., Yeh, H.-W., Chiang, W.-S., Chou, Y.-C., Tsao, C.-H., Wu, Y.-F., & Chien, W.-C.
- Affiliations
- Tri-Service General Hospital (TW)
- National Defense Medical Center (TW)
- Tamkang University (TW)
- Corresponding author
- Chien, Wu-Chien
- ORCID
- Venue
- Neurotherapeutics
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 15
- Issue
- 2
- Pages
- 417-429
- ISSN
- 1878-7479 (ISSN-L)
- PMC
- PMC5935641
- OpenAlex
- W2790037954
- Cited by
- 356
- References
- 67
- Citations by year
- 2026: 34 · 2025: 35 · 2024: 41 · 2023: 40 · 2022: 49 · 2021: 59 · 2020: 48 · 2019: 29 · 2018: 21
- FWCI
- 30.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Neurotherapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Tri-Service General Hospital Research Foundation (TSGH-C105-130, TSGH-C106-002, TSGH-C107-004)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- herpes simplex, dementia risk, antiviral therapy, neurodegeneration, Taiwan
- MeSH terms
- Aged, Antiviral Agents, Dementia, Female, Herpes Simplex, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Taiwan, Proportional Hazards Models
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